Foot Deformities in Arthrogryposis Multiplex Congenita

Södergård, Jerker; Ryöppy, Soini

doi:10.1097/01241398-199414060-00015

Cited by 48 publications

(43 citation statements)

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“…Interpretation of clinical and radiographic results in arthrogrypotic clubfeet remains challenging. There are numerous methods of outcome evaluation for idiopathic clubfeet [25], whereas those concerning syndromic clubfeet are rare [1,6,7]. Evaluation systems proposed for idiopathic clubfeet may not be appropriate for syndromic ones.…”

Section: Discussionmentioning

confidence: 99%

“…Need for radiographic evaluation and control of clubfeet under treatment using various radiographic measurements is controversial since it is often difficult to obtain objective standard radiographs in young children with AMC [1]. Nevertheless, we feel radiographs should be performed during treatment to detect gross pathologies, e.g., pseudocorrections.…”

Section: Discussionmentioning

confidence: 99%

“…Prior initial treatment of arthrogrypotic clubfeet has been aggressive surgical techniques [1][2][3][4][5][6][7][8][9][10][11][12]. The necessity of multiple surgical interventions and high recurrence rate (up to 73%) reported after initial, extensive soft tissue surgery [6] suggest that primary aggressive surgery may not provide satisfactory outcomes, despite short-term results of radical soft tissue releases seeming to be satisfying [5].…”

Section: Discussionmentioning

confidence: 99%

“…Clubfoot is the most frequent indication for surgical treatment in children with arthrogrypotic syndromes [1,2]. Treatment of the clubfoot in patients with arthrogryposis multiplex congenita (AMC) [3] is a challenge due to foot and ankle stiffness and deformity, resistance to correction, tendency to relapse and coexisting hip and knee contractures [1,4,5].…”

Section: Introductionmentioning

confidence: 99%

“…Treatment of the clubfoot in patients with arthrogryposis multiplex congenita (AMC) [3] is a challenge due to foot and ankle stiffness and deformity, resistance to correction, tendency to relapse and coexisting hip and knee contractures [1,4,5]. Most orthopedic surgeons agree that initial treatment for arthrogrypotic clubfeet should begin with serial manipulations and casting followed by soft tissue surgical releases [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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Short-term experience with Ponseti casting and the Achilles tenotomy method for clubfeet treatment in arthrogryposis multiplex congenita

Kowalczyk

Lejman

2008

Journal of Children's Orthopaedics

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Purpose This study presents our experience with the Ponseti method of manipulation and casting followed by Achilles tenotomy (AT) in children with arthrogryposis multiplex congenita (AMC). Methods Five children (ten feet) were followed for at least 24 months after the AT and are the cohort for this study. Their mean age at follow-up was 38.4 months (26 to 48 months), and the average follow-up period was 35.8 months (24-44 months). Treatment was begun within the first months of life. The AT to correct rigid equinus was performed at a mean of 14.4 weeks of life, after 7-10 cast changes (mean 8.4). Clinical criteria by Niki et al. and standard standing AP and lateral radiographs were analyzed for final evaluation. Efficacy of Ponseti casting and AT tenotomy was assessed according to the amount and continuance of the achieved correction. Results Seven feet had clinically satisfactory results. Among the three unsatisfactory feet, there were two (one child) with rocker-bottom pseudocorrections after repeated bilateral AT and one recurrent clubfoot (one child). Six feet required soft tissue releases at 3, 12 and 21 months after the AT due to recurrence of moderate equinus and adductus. Three feet (two children) underwent repeat AT at 10 and 15 months after the primary procedure. The mean interval between initial AT and redo surgical procedures was 11.8 months (range 3-21 months). Two feet (20%) remained without significant deformity after AT.Conclusion Clubfoot in AMC responds initially to the Ponseti method of casting, and deformity may be corrected or diminished. In some children, more extensive surgical treatment can be avoided and in others, delayed. Despite the need for additional surgical intervention, the Ponseti method of casting and AT does seem to be an alternative for initial treatment in children with AMC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Short-term experience with Ponseti casting and the Achilles tenotomy method for clubfeet treatment in arthrogryposis multiplex congenita

Kowalczyk

Lejman

2008

Journal of Children's Orthopaedics

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A Possible Case of Arthrogryposis Multiplex from Medieval Canterbury

Anderson

Thomas

1997

Int. J. Osteoarchaeol.

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Treatment and outcomes of arthrogryposis in the lower extremity

Hamdy

Bosse

Altıok

et al. 2019

American J of Med Genetics Pt C

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In this multiauthored article, the management of lower limb deformities in children with arthrogryposis (specifically Amyoplasia) is discussed. Separate sections address various hip, knee, foot, and ankle issues as well as orthotic treatment and functional outcomes. The importance of very early and aggressive management of these deformities in the form of intensive physiotherapy (with its various modalities) and bracing is emphasized. Surgical techniques commonly used in the management of these conditions are outlined. The central role of a multidisciplinary approach involving all stakeholders, especially the families, is also discussed. Furthermore, the key role of functional outcome tools, specifically patient reported outcomes, in the continuous monitoring and evaluation of these deformities is addressed. Children with arthrogryposis present multiple problems that necessitate a multidisciplinary approach. Specific guidelines are necessary in order to inform patients, families, and health care givers on the best approach to address these complex conditions

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Foot Deformities in Arthrogryposis Multiplex Congenita

Cited by 48 publications

References 0 publications

Short-term experience with Ponseti casting and the Achilles tenotomy method for clubfeet treatment in arthrogryposis multiplex congenita

Short-term experience with Ponseti casting and the Achilles tenotomy method for clubfeet treatment in arthrogryposis multiplex congenita

A Possible Case of Arthrogryposis Multiplex from Medieval Canterbury

Treatment and outcomes of arthrogryposis in the lower extremity

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